Country-Level Governance Indicators as Predictors of COVID-19 Morbidity, Mortality, and Vaccination Coverage: An Exploratory Global Analysis

As the COVID-19 pandemic continues to affect all countries across the globe, this study seeks to investigate the relationship between nations' governance, COVID-19 national data, and nation-level COVID-19 vaccination coverage. National-level governance indicators (corruption index, voice and accountability, political stability, and absence of violence/terrorism), officially reported COVID-19 national data (cases, death, and tests per one million population), and COVID-19 vaccination coverage was considered for this study to predict COVID-19 morbidity and mortality. Results indicate a strong relationship between nations' governance and officially reported COVID-19 data. Countries were grouped into three clusters using only the governance data: politically stable countries, average countries or "less corrupt countries," and corrupt countries or "more corrupt countries." The clusters were then tested for significant differences in reporting various aspects of the COVID-19 data. According to multinomial regression, countries in the cluster of politically stable nations reported significantly more deaths, tests per one million, total cases per one million, and higher vaccination coverage compared with nations both in the clusters of corrupt countries and average countries. The countries in the cluster of average nations reported more tests per one million and higher vaccination coverage than countries in the cluster of corrupt nations. Countries included in the corrupt cluster reported a lower death rate and morbidity, particularly compared with the politically stable nations cluster, a trend that can be attributed to poor governance and inaccurate COVID-19 data reporting. The epidemic evaluation indices of the COVID-19 cases demonstrate that the pandemic is still evolving on a global level.

Perceptions of Parents' Mental Health and Perceived Stigma by Refugee Youth in the U.S. Context

Refugees are at an increased risk of mental health problems due to the multiple traumas experienced. Mental health help-seeking and utilization remains low among resettled refugees in the US, however, with stigma as a major barrier. The goal of this paper was to explore second-generation youth's perceptions of parents' mental health and perceived stigma. Data includes in-depth interviews with 62 Bosnian youth resettled in St. Louis. Results indicate that from the perspective of their children, first-generation refugee parents continue to face mental health challenges. The findings show that parents' and youth's understanding of mental health is tied to cultural stigma surrounding mental health. Additionally, intergenerational trauma might be affecting the child-parent relationship. As mass violence around the world continues and people are at continued risk of becoming refugees, this study contributes by advancing research on the long-term mental health and well-being of refugees and their children.

Role of artificial intelligence-internet of things (AI-IoT) based emerging technologies in the public health response to infectious diseases in Bangladesh

Digital technologies are the need of today to predict, prevent and control emerging infectious diseases. Bangladesh is one of the world's poorest and most densely populated countries and faces a double burden of two deadly diseases, COVID-19 and dengue. In response to both these diseases, the absence of a digital healthcare system and insufficient preparedness, lack of public awareness pose unique challenges and a large threat to the population, resulting in epidemics of escalating severity. This paper suggests a digital health care and surveillance system based on the internet of things (IoT) and artificial intelligence (AI) for timely identification of COVID-19 and dengue cases and improving the prevention and control strategies in the country.

•

Digital technologies enable smart healthcare solutions to sustain and improve health services.

•

Bangladesh is vulnerable to both COVID-19 and dengue epidemics.

•

Epidemic preparedness requires improved digital health policy by integrating AI-IoT based emerging technologies.

•

Campaigning to raise awareness of COVID-19 and dengue infections is a public health urgency.

COVID-19 Vaccine Hesitancy and Emerging Variants: Evidence from Six Countries

As the world tries to cope with the devastating effects of the COVID-19 pandemic and emerging variants of the virus, COVID-19 vaccination has become an even more critical tool toward normalcy. The effectiveness of the vaccination program and specifically vaccine uptake and coverage, however, is a function of an individual's knowledge and individual opinion about the disease and available vaccines. This study investigated the knowledge, attitudes, and resulting community practice(s) associated with the new COVID-19 variants and vaccines in Bangladesh, Colombia, India, Malaysia, Zimbabwe, and the USA. A cross-sectional web-based Knowledge, Attitudes, and Practices (KAP) survey was administered to respondents living in six different countries using a structured and multi-item questionnaire. Survey questions were translated into English, Spanish, and Malay to accommodate the local language in each country. Associations between KAP and a range of explanatory variables were assessed using univariate and multiple logistic regression. A total of 781 responses were included in the final analysis. The Knowledge score mean was 24 (out of 46), Attitude score 28.9 (out of 55), and Practice score 7.3 (out of 11). Almost 65% of the respondents reported being knowledgeable about COVID-19 variants and vaccination, 55% reported a positive attitude toward available COVID-19 vaccines, and 85% reported engaging in practices that supported COVID-19 vaccination. From the multiple logistic models, we found post-graduate education (AOR = 1.83, 95% CI: 1.23-2.74) and an age range 45-54 years (AOR = 5.81, 95% CI: 2.30-14.69) to be significantly associated with reported COVID-19 knowledge. In addition, positive Attitude scores were associated with respondents living in Zimbabwe (AOR = 4.49, 95% CI: 2.04-9.90) and positive Practice scores were found to be associated with people from India (AOR = 3.68, 95% CI: 1.15-11.74) and high school education (AOR = 2.16, 95% CI: 1.07-4.38). This study contributes to the identification of socio-demographic factors associated with poor knowledge, attitudes, and practices relating to COVID-19 variants and vaccines. It presents an opportunity for collaboration with diverse communities to address COVID-19 misinformation and common sources of vaccine hesitancy (i.e., knowledge, attitudes, and practices).

Climate change and dengue fever knowledge, attitudes and practices in Bangladesh: a social media-based cross-sectional survey

BACKGROUND

Bangladesh experienced its worst dengue fever (DF) outbreak in 2019. This study investigated the knowledge, attitudes and practices (KAP) among university students in Bangladesh and significant factors associated with their prevention practices related to climate change and DF.

METHODS

A social media-based (Facebook) cross-sectional KAP survey was conducted and secondary data of reported DF cases in 2019 extracted. Logistic regression and spatial analysis were run to examine the data.

RESULTS

Of 1500 respondents, 76% believed that climate change can affect DF transmission. However, participants reported good climate change knowledge (76.7%), attitudes (87.9%) and practices (39.1%). The corresponding figures for DF were knowledge (47.9%), attitudes (80.3%) and practices (25.9%). Good knowledge and attitudes were significantly associated with good climate change adaptation or mitigation practices (p<0.05). Good knowledge, attitudes and previous DF experiences were also found to be significantly associated with good DF prevention practices (p<0.001). There was no significant positive correlation between climate change and DF KAP scores and the number of DF cases.

CONCLUSIONS

Findings from this study provide baseline data that can be used to promote educational campaigns and intervention programs focusing on climate change adaptation and mitigation and effective DF prevention strategies among various communities in Bangladesh and similar dengue-endemic countries.

COVID-19 Epidemic in Bangladesh among Rural and Urban Residents: An Online Cross-Sectional Survey of Knowledge, Attitudes, and Practices

As other nations around the world, Bangladesh is facing enormous challenges with the novel coronavirus (COVID-19) epidemic. To design a prevention and control strategy for this new infectious disease, it is essential to first understand people's knowledge, attitudes, and practices (KAP) regarding COVID-19. This study sought to determine KAP among rural and urban residents as well as predictors of preventive practices associated with COVID-19 in Bangladesh. A social media-based (Facebook) cross-sectional survey was conducted to explore these variables among Bangladeshi adults. Of 1520 respondents who completed the questionnaire, low level of good or sufficient knowledge of COVID-19 (70.8%) and practices associated with COVID-19 (73.8%) were found. Despite the low level of knowledge and practices, respondents' attitude (78.9%) towards COVID-19 was relatively high. Results suggest that compared to urban, rural residents are at a particularly high risk of COVID-19 because they were found to have significantly lower knowledge (p = 0.001) and practice levels (p = 0.002) than were urban residents. Multivariable logistic regression analysis identified gender, education, knowledge of COVID-19 transmission, signs and symptoms, and sources of information as factors significantly associated with preventive practices against COVID-19. Further attention and effort should be directed toward increasing both knowledge and practices targeting the general population in Bangladesh, particularly the rural and less educated residents. Findings from this study provide baseline data that can be used to promote integrated awareness of and effective health education programs about COVID-19 prevention and control strategies in Bangladesh, and similar COVID-19 endemic countries.

The impact of COVID-19 on globalization

Globalization has altered the way we live and earn a livelihood. Consequently, trade and travel have been recognized as significant determinants of the spread of disease. Additionally, the rise in urbanization and the closer integration of the world economy have facilitated global interconnectedness. Therefore, globalization has emerged as an essential mechanism of disease transmission. This paper aims to examine the potential impact of COVID-19 on globalization and global health in terms of mobility, trade, travel, and countries most impacted.

The effect of globalization were operationalized in terms of mobility, economy, and healthcare systems. The mobility of individuals and its magnitude was assessed using airline and seaport trade data and travel information. The economic impact was measured based on the workforce, event cancellations, food and agriculture, academic institutions, and supply chain. The healthcare capacity was assessed by considering healthcare system indicators and preparedness of countries. Utilizing a technique for order of preference by similarity to ideal solution (TOPSIS), we calculated a pandemic vulnerability index (PVI) by creating a quantitative measure of the potential global health. The pandemic has placed an unprecedented burden on the world economy, healthcare, and globalization through travel, events cancellation, employment workforce, food chain, academia, and healthcare capacity. Based on PVI results, certain countries were more vulnerable than others. In Africa, more vulnerable countries included South Africa and Egypt; in Europe, they were Russia, Germany, and Italy; in Asia and Oceania, they were India, Iran, Pakistan, Saudi Arabia, and Turkey; and for the Americas, they were Brazil, USA, Chile, Mexico, and Peru. The impact on mobility, economy, and healthcare systems has only started to manifest. The findings of this study may help in the planning and implementation of strategies at the country level to help ease this emerging burden.

'Makin' it' in the Heartland: Exploring perceptions of success among second-generation immigrant youth in St. Louis

INTRODUCTION

Debates in the literature on youth transitions and on immigrant adaptation acknowledge that recent societal shifts have altered the conditions for young people growing up today. As a result, traditional notions of success may limit our understanding of the mechanisms that lead to differential transitional and adaptation pathways among today's children of immigrants. This study explores the definitions of success among a sample of Bosnian-origin youth in St. Louis.

METHOD

The analysis is based on the first wave of in-depth qualitative interviews with 58 Bosnian second-generation youth (age 15-23) in St. Louis. Interviews lasted 45-90 min, were conducted in English, transcribed and coded following an inductive analytic logic.

RESULTS

Overall the respondents complemented traditional notions of success, such as material stability and family formation with more subjective indicators such as self-fulfillment and happiness.

CONCLUSIONS

The findings highlight the importance for future waves of data collection to trace how definitions of success evolve and how they shape particular trajectories of the youth in our study. On a more general level, these findings urge researchers to incorporate definitions of success that are not primarily based on social and economic status mobility in an effort to generate a more nuanced understanding of the adaptations and transitions to adulthood of today's children of immigrants.

Retrospective data analyses of social and environmental determinants of malaria control for elimination prospects in Eritrea

Background

The present study focuses on both long- and short-term malaria transmission in Eritrea and investigates the risk factors. Annual aggregates of information on malaria cases, deaths, diagnostics and control interventions from 2001 to 2008 and monthly reported data from 2009 to 2017 were obtained from the National Malaria Control Programme. We used a generalized linear regression model to examine the associations among total malaria cases, death, insecticide-treated net coverage, indoor residual spraying and climatic parameters.

Results

Reduction in malaria mortality is demonstrated by the milestone margins of over 97% by the end of 2017. Malaria incidence likewise declined during the period (from 33 to 5 per 1000 population), representing a reduction of about 86% (R² = 0.3) slightly less than the decline in mortality. The distribution of insecticide treated nets generally declined between 2001 and 2014 (R² = 0.16) before increasing from 2015 to 2017, while the number of people protected by indoor residual spraying slightly increased (R² = 0.27). Higher rainfall was significantly associated with an increased number of malaria cases. The covariates rainfall and temperature are a better pair than IRS and LLIN to predict incidences. On the other hand, IRS and LLIN is a more significant pair to predict mortality cases.

Conclusions

While Eritrea has made significant progress towards malaria elimination, this progress should be maintained and further improved. Distribution, coverage and utilization of malaria control and elimination tools should be optimized and sustained to safeguard the gains made. Additionally, consistent annual performance evaluation of malaria indicators would ensure a continuous learning process from gains/threats of epidemics and resurgence in regions already earmarked for elimination.

Examining the role of training in evidence-based public health: a qualitative study

The use of evidence-based public health (EBPH) approaches is generally recognized as essential to changing public health outcomes. However, using an EBPH decision-making process requires public health practitioners to have the skills to review the evidence and pick the most workable strategy to address the problem at hand for their population of interest and the local context. Although there has been a growing body of academic literature examining the skills needed to translate evidence-based programs in local settings, many public health practitioners have not had the opportunity to learn or develop these skills. This article reports on qualitative interviews conducted to evaluate the process and impact of an EBPH course. The course has been found to assist participants in integrating new and existing skills to make evidence-based decisions. However, participants emphasize that factors external to the course influence their ability to engage in the EBPH process they learned.